Tuesday, June 07, 2005

PTSD, Abortion, and Chronic Pain

As established in the last segment, abortion is intrinsically traumatic, although not all will be traumatized by it. But some women will develop a form of post-traumatic stress disorder known as post-abortion stress syndrome, or PAS. The existence of PAS is in dispute in the medical community, for what I can only imagine are ideological reasons that have nothing to do with health or care. As discussed previously, even abortion clinic workers are traumatized by what they are doing, and many of them claim to be doing it for benevolent reasons. It is clear then that the perceived benefit of abortion is no defense against being traumatized by it. Many women do not express regret over their abortions because they believe the abortions helped them, and sometimes they even believe the abortions helped the unborn child. We’ve already seen, though, that guilt and regret are absolutely unnecessary in the development of post-traumatic stress disorder. The perpetrator can indeed be traumatized by her own actions because the traumatic response occurs in the brain at a fundamental level that does not consider the belief systems she may have constructed that justify these actions. When she develops post-traumatic stress disorder, she is responding to the perceived threat against her own life that is inherent in the destruction of the life held so intimately in her own body.

But while guilt is not a factor in the development of PAS, a feeling of helplessness is, according to Dr. Robert C. Scaer, MD, author of The Body Bears the Burden: Trauma Dissociation and Disease (The Haworth Medical Press, 2001). In his words, PTSD “is produced by threat, shock, or injury that occurs in a state of helplessness,” (Scaer, p.xxi). In the animal kingdom, we see three different responses in situations which threaten the survival of the animal: the fight/flight/freeze response. Most of us are familiar with the fight or flight response. The freeze response is less commonly understood, according to Dr. Scaer. When the animal is helpless, unable to flee or defend itself against a threat, nature provides a third mechanism by which it might possibly survive: the animal freezes in an instinctual and unconscious reflex into a state of immobility, created and sustained by the parasympathetic nervous system, a division of the autonomic nervous system.

Sometimes the predator, faced with prey that is suddenly and entirely immobile as if dead, gives up and the animal survives – “playing possum.” Additionally, in the freeze response, the brain releases endorphins, which we all know as the body’s natural pain killers. Dr. Scaer remarks, “Whether this analgesia has survival value, or is a gift from a greater Being to prevent a painful death is open to debate,” (Scaer, p. 16). Another reason for the animal to be dissociated from the pain might be to keep it from its natural desire to tend to its wounds before it has completely reached safety, just as endorphins work in the flight or fight response to keep the animal from feeling pain that would impede either action.

Following the freeze response, there is a “discharge” of this autonomic nervous energy, which has been stored while the animal mimicked death. Animals in the wild and in the laboratory have been observed to tremble and perspire when they arouse from the freeze response, and oddly enough, the first movement they make is often a postural representation of what they were doing at the exact moment the freeze response was invoked – their legs will work as though running, for example, if they froze while being pursued, even while they are still lying on the ground. This is indicative of a period of unconsciousness or amnesia.

Dr. Scaer postulates that the freeze response exists in humans, but not usually to the extent it is seen in the animal kingdom. He describes it as the psychological equivalent of dissociation, in which specific, anxiety-provoking thoughts, emotions, or physical sensations are separated from the rest of the psyche: “…people [suffering trauma]…will frequently relate that they felt as if they were ‘in shock.’ This is often related as a sense of detachment, numbness, and even confusion. Time often seems to stand still. Some patients report that they feel as if they are detached and removed from their body, occasionally reporting the events of the trauma as if they were seeing them as a third person…many of the posttraumatic symptoms that occur often for years after the unresolved trauma are characteristic of dissociation, or recurrence of the symptoms of freezing,” (Scaer, p. 19).

Humans also don’t seem to have a period of discharge of autonomic nervous system energy after trauma, either, which leads Dr. Scaer to speculate that “the self-perpetuated circuitry involved in kindling is remarkably compatible with absence of discharge…” (Scaer, p. 20). “Kindling” results from the build-up of nervous energy that is not dissipated. Dr. Scaer believes that without the dissipation of this autonomic nervous system energy, “the ‘survival brain’ may continue to perceive that the threat continues to exist, and is unable to relegate it to memory as a past experience,” (Scaer, p. 21). In other words, post-traumatic stress disorder is physiologically expressed by autonomic nervous system dysfunction.

Kindling refers to the spontaneous combustion of materials reaching a certain critical temperature. In neurological terms, kindling refers to the process by which electrical impulses can add up and trigger spontaneous responses. The PTSD nervous system smolders with undischarged energy that bursts into full flame, and the resulting neuropsychological symptoms include flashbacks, intrusive memories, cue-related memories, nightmares, anxiety, panic attacks, phobias of events and places reminiscent of the trauma, memory and situation-induced arousal, mood changes, irritability, stimulus sensitivity (to light and sound, for example), exaggerated startle response, and insomnia. Furthermore, because the autonomic nervous system is involved, there are “often dramatic physical symptoms, including bowel disorders, myofasical pain, and cognitive impairment….We therefore seem to be dealing with a syndrome affecting all aspects of a person’s being, including body, mind, and spirit,” (Scaer, p. xxi).

This leads Dr. Scaer (and others) to the conclusion that “many of those chronic diseases that seem to be the most common,” and the most difficult to treat, “may well have their roots in the insidious systemic effects of traumatization,” (Scaer, p.21). He continues, “in fact, I believe that the most common complaint in current medical practice, that of persistent and unexplained chronic pain, has its roots in the persistent changes in brain circuitry associated with unresolved traumatization, and the continued tendency for dissociation to occur in the face of stress or threat,” (ibid). He describes the disorders resulting from post-traumatic stress disorder as psychophysiological, and they include fibroymalgia, chronic fatigue syndrome, reflex sympathetic dystrophy, and somatization disorders that drive people to doctor after doctor, seeking a diagnosis for that which apparently cannot be explained. Dr. Scaer is very sympathetic to these patients, adding that they suffer the burden of being retraumatized and devalued by a medical community that will deny the physical validity of their very real pain (Scaer, p. 81).

The physical complaints associated with post-traumatic stress disorder include headaches, gastrointestinal complaints, immune system problems, dizziness, chest pain and other pains throughout the body. NIMH explains that “Often, doctors treat the symptoms without being aware that they stem from PTSD. NIMH, through its education program, is encouraging primary care providers to ask patients about experiences with violence, recent losses, and traumatic events, especially if symptoms keep recurring.”

One of the most mysterious of the psychophysiological disorders is fibromyalgia. More than 90% of those diagnosed with fibro are women of reproductive age. Researchers have already noted that large numbers of those women diagnosed with fibromyalgia have some kind of trauma in their histories – most often, it is childhood physical and/or sexual abuse. The physical symptoms of fibromyalgia include: headaches, fatigue, pain, vertigo (dizziness), chest pain, irritable bowel syndrome, low-grade fever and flu-like feelings. It seems likely that Dr. Scaer and the National Institutes of Mental Health are correct in speculating that fibromyalgia and its cousins may actually be undiagnosed post-traumatic stress disorder, undiagnosed in my opinion because physicians and researchers aren’t able to identify a source of trauma – but then, they aren’t looking for abortion in our medical histories. For the most part, it seems the medical community is standing around scratching its collective head while women get sicker and sicker with illnesses they can’t quite diagnose or understand.

As we can see from Dr. Scaer’s model of the freeze response, helplessness is a primary factor in determining whether a traumatic event will be traumatizing. According to the Elliott Institute’s report, Forced Abortion in America, eight in ten women who had abortions report they would have chosen to give birth instead if they had received support and encouragement from friends and family. The woman who aborts her child because she feels she has to, because she is financially, socially, or otherwise isolated and without help submits to a procedure that results in violent death, and is primed to develop post-traumatic stress disorder as a result.

Not all women who have abortions will develop PAS, as I’ve mentioned before, but that shouldn’t ease our minds. Most people who suffer from post-traumatic stress disorder have multiple traumas in their histories which did not at that time trigger symptoms of PTSD, but which weakened them against future traumas, making them more susceptible to develop the disorder each time. Also, the symptoms of PTSD appear on a continuum – some will suffer less than others. Again, each successive traumatic event will be more difficult to handle, and, because of the kindling effect in the nervous system, it actually takes less severe trauma to incur the most severe results as time and stress march on. Occasionally, I have to take a second look at the title of my blogspot – abortion hurts. We have been practicing unrestricted abortion on demand in this nation for thirty years without regard to the consequences, and without medical research that determines whether or not this is really as benign a procedure as we are promised it will be. It's pretty clear to me, though, that the evidence is already in. Not only is abortion not benign, it is malignant, and it is making us sick.


At 6:00 PM, Blogger Emily said...

This is such a great series!

At 8:40 PM, Anonymous Robin L. in TX said...

My sister-in-law was sexually abused as a child. You've listed many of her symptoms. She thinks the trauma that led to her physical problems came from an automobile accident. I no longer think so...

This is a great series. You are helping me so much as I learn more so I can be of more help to the women that come to our pregnancy care center.

Our God is an awesome God who forgives us of everything we repent, and brings good out of the evil that we choose. God bless you and surround you with His peace and joy.

Robin L. in TX

At 10:42 AM, Blogger achromic said...

That's what fibromyalgia is? Shoot I never knew... jeeze I have those kind of problems all my life. I just never complained to anyone about them.

I think in part of PTSD thing is because it can take time to manfiest and because someone maybe suffering from mutlipul tramas to the psychological/emotional part of her brain I donno how you can link it with abortion vs. linking it to the abuse.

At 7:34 AM, Blogger Silent Rain Drops said...

Thank you all so much for your comments - especially yours, Robin, because I am really grateful to God and humbled if anything I write here helps you to help others - thank you.

This week I'll be posting more about how multiple traumas work - there is so often more than one source of trauma, that it appears there is a cumulative effect.

Dr. Scaer began his research because he had patients who were exhibiting extreme physical symptoms after what should have been mild trauma: low-speed motor vehicle accidents with no apparent injuries resulting in people with severe whiplash syndrome (which has the same symptoms as fibro). When he looked into it, he found this cumulative effect in that most of these patients had a history of trauma before the low-impact accidents that caused their full-blown symptoms.

I didn't start developing PTSD symptoms until after my abortion; my earlier traumas, including a motor vehicle accident, helped set me up for it, but I manifest the most extreme symptoms around the abortion trauma - avoidance, aversion, triggers, etc., are all abortion-related. I have no such problem with bicycles, for example, even though I was riding one when struck by a car, and it was quite serious.

So, Achro, as you say, we link the PTSD to the patient's entire traumatic history, because all of them work together to weaken our defenses.

At 9:08 PM, Blogger achromic said...

It makes me think that the abortion starts before the actual act. That the intervention at the time is too late. I keep going over and over in my head about my own abortions and I just keep coming back to it all needed to stop before it happened... I need a way out before I knew I needed a way out. Once in crisis that deer in the headlights.... boy that sounds about right... and the fear and the confusion and trying to figure it all out.

At 7:43 PM, Blogger achromic said...

are you ok? I hope so. I'm thinking about you. :)

At 9:07 AM, Blogger Silent Rain Drops said...

Thank you so much, Achro. I'm hanging in there - I hope you are getting well.

I'm sorry I've been slow on the next installment, but I will have something in a day or so for sure. I forget that I also suffer from this, and I get hung up in certain areas. The next topic is going to involve maternal bonding, and I have to research some pregnancy facts. Ugh. I have a problem, eh? ;) Thanks for hanging in there with me!

At 7:51 PM, Blogger achromic said...

Yea that happens to me too. I get into something and then suddenly I donna want to talk about it anymore. Naamen does that to me and so does Annie quite a bit. I do secretly wish tho' that some of you could be a fly on the wall and hear how much discussion you guys bring to the table. Blogging has really helped people listen.....

LOL speaking of ... you wanna know what my doctor just said... she said "well it sounds like you have chronic pain." I was flipping out about it until I came here to check on you... and now I'm thinking... well maybe I do...

At 9:28 AM, Blogger Julie said...

Just read all this very ineteresting stuff. I would just like to add that listing the traumas and releasing it with emotional freedom technique seems very helpful for me, een though it's like reliving those awful events but thenn you can think of them with no emotional response. It's the best healing tool I have found after years of all the other therapies out there.

At 5:58 AM, Blogger Carol said...

I know this blog is dated, but I just came across it and thought I would post.

I can confirm that what's been said here is true.

12 years ago, I had what is sometimes termed a "coerced" ab. My husband and I had two children when I became pregnant with our 3rd. After long debate, he finally said "Choose. The baby or me." For other reasons I won't describe, I lost. It was a kind of "Sophie's Choice.

What ensued, though, is exactly what is being described here. I entered a 10 year depression that was accompanied by physical symptoms that doctors were convinced were brain tumors and then MS. Ringing in my ears, numbness in my feet, stumbling, tingling in arms and legs, vertigo, trembling in my hands, cognitive impairment (where I would read to my daughter but couldn't get the words to come out of my mouth right).

It was as though I had fried my body's circuits. AT times of stress, these symptoms would reappear, which has lasted for many years.

It's very, very real.

At 5:58 AM, Blogger Silent Rain Drops said...

Hello, Carol - I'm so glad to hear from you. Yes, these posts were written some time ago, but in that time, researchers are learning more and more about what we have suffered and that we do suffer. So I'm glad you were still able to find it. I'm hoping to rewrite the series as one cohesive document, using more current research, too.

Please know that I will keep you in my thoughts and prayers; I hope you will be able to find some comfort and relief for your symptoms; have you looked into counseling? Groups are good for helping rewire the circuitry; and there are some therapists who are specifically trained in techniques such as eye movement desensitaziation therapy, a process in which the traumatic memories are brought out while the patient's autonomic nervous system is stimulated, either by voluntary eye movements or sensory input (tones, for example). And no good therapist would argue whether your abortion was traumatic, because it was coerced - if you find one who wants to invalidate your feelings, then you'll know to move on.

Please stay in touch. I would like to know how you are getting on.

At 8:28 PM, Blogger ♥aisyateru ♥ said...

i may disgress a bit..
but i actually,want to ask your opinion
of how you see abortion of fetus with severe genetic disorders?

At 7:01 AM, Blogger Silent Rain Drops said...

Hello, aisyateru,

Thank you for the question. It's timely and important to discuss.

First, there would be no difference in the mother's response to the abortion. As you may have read here, the reasons we abort have little bearing on the consequences. Life is threatened, life is taken, the body invaded, the pregnant brain interrupted alarmingly in its sudden loss of purpose. Whether we justify it or not in our conscious mind is irrelevant.

Secondly, there may be other, specific sorrows that make it even worse - often the child was wanted. The mother will have a sense of loss and grief that is particular to this - the decision whether to raise a child with special needs is difficult. Too often, she bears the burden of making the decision because she is told she is inadequate to the task, yet she still loves the child she carries, whether it is perfect or not - and don't we always love each other in spite of all kinds of flaws? After all, no one is perfect, and if love depended on perfection, there would be none in the world.

Third, I disagree with it on principle. Sick people, handicapped or deformed people, mentally retarded people, "brain dead" people (another subject for long discussion) are still human beings. They have a right to life, and their deaths still affect us personally and potentially leave scars of trauma.

Also, on this last point, we should never assume that life should be ended because we can't see its purpose, or any quality in it. There is something to be said for the compassion that caring for the sick and disabled brings out in other people that makes their existence necessary and meaningful in the world. We can't know all ends, and should not make decisions that are above us - and it is a judgment call. By aborting children with genetic disorders of any kind, we are saying they are not as worthwhile as other people; yet all human life is equal in value. A man born with full functioning doesn't become less of a human being if he is injured and becomes paraplegic later in life. A child isn't less human if he or she has a congenital disorder, either. That part of the brain that responds with alarm to human death does not make such distinctions.

And who decides which genetic disorders or birth defects demand the death penalty? We have charitable organizations like Doctors Without Borders traveling the world to correct cleft palate, particularly since it is a fairly simple and low-cost way to change someone's life. At the same time, and this is documented in Great Britain, we have a woman who aborted a child because he/she had cleft palate. I guess he or she was not going to be perfect enough. I hate catch phrases, but this is a perfect example of the slippery slope we encounter when we try to decide who should live, and who should not.

Lastly, I would argue that abortion is just too easy. It would be better to find cures for these disorders; but as long as we can resort to sending the child back to the manufacturer through abortion, we will not strive to find a way to correct these problems.

I hope I have answered your question to the best of my ability. And if you are troubled by this choice, or know someone who is, please accept my compassionate understanding and sympathy.

At 1:51 PM, Blogger nurse2socialworker said...

I was interested in your description of the fight/flight/freeze syndrome. Although trained as a nurse and a social worker, I have never come into contact with the terminology "freeze" syndrome. It explains a lot about what I have experienced in my life and what I have seen happen to others in their lives as I have had occasion to counsel with them whether as a nurse or as a social workier. Thank You!

At 7:18 PM, Blogger Silent Rain Drops said...

Dear nurse2social worker,
I can't tell you how happy I am that you came across my blogspot, and learned about something I didn't know of, either, until I did some research. Other neurologists have theories regarding the freeze response, and they also specialise in trauma - Dr. Bessel Van der Kolk is one.

It is well worth our while to examine the similarities between the documented freeze response in mammals and dissociation in humans. It will help us to help those who seek our aid. You are one of the few health professionals I have heard from who has the grace to admit there is more to learn. Thank you for that - your patients are truly blessed by you.

I once saw a distressing news report of a terrible car accident on I-10 in Arizona. A semi-truck driver was involved, and he was trapped in his burning vehicle. He was still alive after the initial impact. I watched the news footage as they interviewed one of the witnesses, a fully-adult man who wanted to help, but, like the other witnesses was driven away by the heat and fire, he experienced this sense of helplessness in the face of human suffering and death.

He related the story so very distantly - in fact, he looked away from the interviewer and camera as he spoke of hearing the man's screams and describing his own, and others, inability to help; he seemed to be lost in memory, and not "present." It was classic dissociation from a psychological perspective, and once taken into consideration with the freeze response documented in the animal kingdom, quite understandable as such. He and the others who tried and failed to help the man who died so painfully and tragically before their eyes were so fundamentally affected. We must never underestimate the human response to the suffering and death of other human beings.

Thank you so much for visiting here. I recommend, because of your education and training, that you go to the original sources cited, and others that have popped up as research progresses in this area. You are and will be a valuable asset to human health and happiness.

Thank you again, and Godspeed!


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